File - Sunnybrook Health Sciences Centre

Patient and Family
EDUCATION NEWS
SUMMER 2015
I’m feeling
GASSY and
BLOATED
today...
What if I
rol
can’t cont
er?
my bladd
I’m not sure I
can talk to my
doctor about this...
What if I get
addicted to my
pain pills...?
Will I
be abl
e to
have s
ex d
treatm uring
ent?
any
e
r
the r men?
e
r
A
fo
s
m
a
r
prog
“Let’s talk about it!”
PATIENT & FAMILY EDUCATION NEWS SUMMER 2015
Ashraf ’s Story
This is your cancer journey!
Be honest.
Learning from other cancer patients is
extremely important and valuable. But it
is important to remember not all patients
are alike and some of the patients are in
shock, family members are in shock, you
may be in shock. All of this shock and
emotion may not lead to getting the best
or most appropriate information for you.
It is so important to tell the truth to
your healthcare team. Don’t lie about
your symptoms like vomiting or diarrhea
because you are afraid you won’t be able
to have your treatments. Being honest
about how you are feeling will help you.
Don’t be easily influenced. Educate yourself
about treatments, supports and the help that
is best for you.
You shouldn’t be afraid of:
Picking and choosing the pieces of advice
that work best for you! You will hear a
lot of opinions and stories from other
patients, family members and friends
when you have cancer - they are trying to
comfort you.
The best thing to do is talk to your
healthcare team and definitely they can
help you with what you need, always listen
to them and if there is anything you do not
understand – do not be shy to ask for a more
detailed explanation.
Some men might put up a brave front and
don’t want to be honest about how they are
feeling with their loved ones. Being brave
for your family is important. But only you
know what you are going through. Your
family and loved ones can offer you better
support if you don’t hide your cancer. And
if they can’t provide that support at least
they will know how you feel and hopefully
not have false expectations.
If you have to prepare your family for harsh
news – honesty is the best medicine.
My advice to Sunnybrook
staff:
Tell me about all of the services that are
offered in this building and out in the
community. It can be hard for patients
to ask.
Make it simple. Please speak in plain
language. Patients need to understand
what you are telling them.
My advice to other patients:
Ask the right questions. All of the
questions you have. Don’t be shy it’s your
life!
Also don’t google your symptoms. That
is always scary. If you are going to google
medical information, ask your doctor.
Don’t feel bad about seeking out psychosocial support from a psychiatrist or
psychologist if you need it. My caregiver
told me this and I stand by it. “Don’t torture
your body anymore”. Get the help you need.
My final words of wisdom
are:
What doesn’t kill you will make you
stronger!
Ashraf Fanous is a member of the Patient and Family Advisory Council at the Odette Cancer Centre
1
EDUCATION: WHEN IT MATTERS MOST Sexual Health and your Cancer
Patients shouldn’t feel embarrassed to talk about....Sexual activity during radiation therapy treatment.
ANGELA TURNER MRT(T). BAHons
Research Radiation Therapist
Many people have questions or concerns
related to sexual activities while receiving
radiation therapy treatments but do not
ask. These questions might be because
of embarrassment, not knowing who to
ask, or fear of judgments that the health
care team will consider these issues
trivial. Maintaining your usual lifestyle,
including sexual activities, is important
during treatment. Intimacy with loved ones
provides support and comfort at a time
when you might need it most.
Concerns that people might have include fears
that they might harm their sexual partner,
because they are radioactive. Radiation
therapy treatments do not make patients
radioactive and there are no restrictions
around being close to others. There are some
specialized radiation therapy treatments
that may involve taking certain precautions
after treatment. Please feel free to ask your
healthcare team at any time about any special
restrictions you might have to follow.
for urine and semen) is in the treatment area.
They might feel pain when they ejaculate as
the lining of the urethra might be red and
swollen due to radiation reactions.
Tips or Strategies:
It is normal to have less energy
during treatments and you
may have less interest in sexual
activities. You can still find
ways to stay close to partners
and loved ones and maintain
intimacy.
•
•
•
Talk to your partner about
how you feel; write your
thoughts down if talking is
difficult.
Plan sexual activities for
times of the day or week
when you know you will
have most energy.
Maintain closeness and
intimacy with your partner
and loved ones through
touch e.g. kissing and
cuddling, holding hands,
hugging.
As treatment goes along, depending on the area
that is being treated, there may be side effects
that may make certain activities uncomfortable:
Resources available:
General side effects of treatment like fatigue
(lack of energy) may mean that you have
no desire for sexual activities.
There are written resources available to
explain about side effects of radiation
therapy and how it relates to sexual health.
Skin reactions might make hugging and
touching uncomfortable depending on the
area being treated.
- Sexual Health and Radiation Therapy:
A Guide for Men.
Women who have the pelvic area treated
might find intercourse too uncomfortable
because of the radiation reactions that take
place inside the vagina. Vaginal tissues
can become red, swollen and sensitive and
that might make intercourse painful as
treatment progresses.
Men who have their pelvis treated might also
experience discomfort if the urethra (tube
- Sexual Health and Radiation Therapy:
A Guide for Women
As well, there is a general booklet from the
Canadian Cancer Society “Sexuality and
Cancer “that covers all aspects of the topic.
Canadian Cancer Society (www.cancer.ca)
Sexuality and Cancer Booklet
There are also books available if you want
to learn more about the topic of sex and
sexuality that are written for cancer patients.
Man Cancer Sex
Each chapter describes the experience of
men with different types of cancer and the
problems they may face, including pain,
loss of libido, erectile dysfunction, fertility
issues, and more.
- Anne Katz. Hygeia Media; 1 edition
(September 1, 2009
Woman Cancer Sex
Each chapter describes the experience of
a woman with a particular kind of cancer
and a variety of related problems, including
loss of libido, physical pain, and struggles
communicating with a partner.
- Anne Katz. Hygeia Media; 1 edition
(April 1, 2009)
There is a sexual health clinic for women,
SHARE (Sexual Health and Recovery)
where you can discuss sexual health issues
one to one. Ask your health care team to
refer you or you can call yourself to make an
appointment: Tel 416 480 5000 ext.81022
Male patients who wish to talk to someone
about their sexual concerns can ask their
health care team to refer them to specialists
who are here to help.
Please feel free to contact Clinical Specialist
RT Supportive Care and Sexual Health Tel:
416 480 6100 ext 85225. Angela.turner@
sunnybrook.ca
You can also connect with our Patient and
Family Support Program, ground floor, TG
230 in the Odette Cancer Centre.
Sexual health is part of your overall health and
it is important to us that your questions and
concerns are answered. There are solutions to
help you with your issues and answers to help
address your concerns so talk to us!
2
PATIENT & FAMILY EDUCATION NEWS SUMMER 2015
Nutrition &
Gas
Call it breaking wind, tooting
or passing gas…everyone does
it! In fact, it is normal for the
average person to pass gas 10
to 25 times a day.
EDITH STOKES, Registered Dietician
& TRACEY RAPIER, Registered Dietician
When you are diagnosed with cancer you
may start to notice more gas. This can relate
to medications, treatment, changing diet
and constipation (not being able to poo).
There can be many reasons for producing
more gas, but the most common is eating
certain types of foods that create gas in the
bowel. Food that contains starch and dietary
fibre will produce gas as they are digested.
People who are having radiation treatment
to the pelvic regions of the body can develop
gas because radiation can irritate a portion
of your bowel . As a result, excessive gas can
occur. This usually begins about 2–3 weeks
into radiation therapy. In fact, you may be
asked by a radiation technician to go for a
walk to try to reduce the gas before your
treatment if there is lots of gas in your bowel
at the time of your treatment.
If you would like help with reducing gas,
make an appointment with the Registered
Dietitians at the Odette Cancer Centre.
This service is free to all Odette Cancer
Centre patients undergoing treatment. You
can also speak to your doctor if you feel
that your gas problem is excessive, painful
or chronic (keeps coming back). Your
doctor will determine if you need medical
treatment for your gas.
You may find gas to be embarrassing and
sometimes even annoying. Remember some
gas is a normal part of our digestion and
as Hippocrates professed “Passing gas is
necessary for well-being”. Also, if your gas
is excessive during treatment remember this
is usually temporary and will go away once
treatment is finished and the inflammation
decreases… or in other words “this too
shall pass.”
3
Tips or Strategies:
To help with gas try:
• Try to have 5-6 small
meals a day.
• Drink lots of fluid between
your meals.
• Do not over eat.
• Eat slowly and chew your
food well.
• Take small sips from your
drink and drink slowly.
Avoid using a straw, (as
this can make you take in
more air).
• Avoid foods that contain
air, like pop and whipped
cream.
• Do not skip meals as an
empty stomach can make
gas worse.
• Avoid smoking or using
tobacco products.
• Try not to talk while you
eat, chew gum, suck on
hard candy, drink alcoholic
and/or fizzy drinks to
reduce swallowed air.
• Exercise regularly. Try to
take a walk after meals.
• Try products like Beano to
reduce gas.
• Treate constipation.
You can try to eat smaller
amounts of the foods that
are most likely to cause gas
to see if this helps reduce the
problem. These foods include:
• Pulses (such as peas, beans
and lentils)
• Vegetables from the
brassica family (such as
brussel sprouts, cabbage
and artichokes)
• Onions
• High-fibre food such as
bran
• Fizzy drinks.
EDUCATION: WHEN IT MATTERS MOST Recipe
Mint Lassi
A mint lassi is mint and yogurt blended together, making a smooth
and refreshing drink. Try it on a hot day! The mint and the bacterial
culture in the yogurt may help your gut feel fantastic!
Makes two servings of Mint Lassi.
Ingredients:
1 cup loosely packed mint leaves
2 cups plain yogurt
2 Tbsp. sugar, honey, or agave syrup, or to taste
1 tsp. lime or lemon juice
Preparation:
Put the mint, yogurt, sweetener of choice, and lime juice in a
blender. Whirl until smooth. Taste and add more sweetener
or lime juice, if you like. Pour into glasses and serve.
4
PATIENT & FAMILY EDUCATION NEWS SUMMER 2015
Patients shouldn’t feel embarrassed to talk
about… addiction
A behaviour that is felt to be out of one’s control in some way and is often thought of when
talking about certain pain or stress relieving medications.
MARK PASETKA, B.Sc., B.Sc.Pharm., Pharm.D., R.Ph.
Normalizing the Concern:
Patients who are having severe pain can
be given strong pain killing medications
by their doctor to help control this
symptom. These medicines work very
well to take away the pain, but many
people think they can become addicted
to or mentally dependent on them and
will be identified that way.
The Centre for Addiction and Mental
Health (CAMH) describes addiction by
the presence of the four “C”s:
1. Craving
2. Loss of Control of amount or frequency
of use (meaning someone takes more
pills than is supposed to and/or more
often than was supposed to).
3. Compulsion to use
4. Use despite Consequences
There is a difference between someone
becoming addicted and someone becoming
physically dependent.
Dependence (physical) is not uncommon
and can occur with many medications
including those used to treat high blood
pressure, mood, pain, and too much
stomach acid. Dependence in simple terms
means your body becomes used to having
the medicine around. If you suddenly
stopped such a medication, side effects
(called withdrawal effects) can occur.
A common example of this can occur
with coffee drinkers. People who drink
coffee on a regular basis and then stop can
experience headaches. This is due to the
sudden absence of caffeine (which is found
in coffee), to which your body reacts by
causing a headache. These effects do NOT
5
mean that you are addicted to coffee (or
caffeine) it simply means that your body is
reacting to not having the caffeine around.
Tips or Strategies
If you are concerned about
becoming addicted or think
you may be addicted to a
medication please consider the
following:
• Speak with your doctor,
nurse, or pharmacist about
your concerns.
• They can answer questions
regarding your medications
and whether they have the
potential to be addictive.
• They can also assess you for
addiction risk.
Resources Available:
A number of resources are available
and include internet-based resources,
documents, and centres/organizations
specific to addiction:
Centre for Addiction and Mental Health
(CAMH): www.camh.ca
Metro Addiction Assessment Referral
Service (MAARS) [Part of CAMH]:http://
www.camh.ca/en/hospital/care_program_
and_services/addiction_programs/Pages/
guide_maars_clinic.aspx
University Health Network:
http://w w w.uhn.ca/PatientsFamilies/
Health_Information/Health_Topics/
Documents/Resources_for_Addictions.
pdf#search=resources%20for%20addiction
City of Toronto:
http://www1.toronto.ca/wps/portal/conten
tonly?vgnextoid=7f2964445c780410VgnV
CM10000071d60f89RCRD&vgnextchan
nel=5e018fb738780410VgnVCM1000007
1d60f89RCRD
Phone Numbers:
CAMH: (416) 535-8501, press 2
MAARS: (416) 599-1448
Drug & Alcohol Helpline:
1-800-565-8603
Finally…
Please feel free to speak with any member
of the health care team regarding your
concerns about addiction and let us help
you address your questions.
If you are a patient at the Odette Cancer
Centre and would like to talk about your
concerns with medications please connect
with our Pharmacy T-Wing, First Floor.
Open Monday to Friday, 8:30am to
5:00pm, 416-480-4671
You can also visit the patient and family
support office and speak with a social
worker or psychologist about your concerns
related to addiction. T-Wing, Ground
Floor, T-230, 416-480-4623
EDUCATION: WHEN IT MATTERS MOST Guys Get It
Based on the experiences shared by the men in the monthly Taking Charge: Men’s Program
(offered at Wellspring’s Westerkirk House, at Sunnybrook and Birmingham Gilgan House in
Oakville) there is no doubt that men are eager to talk openly about some of the more private
issues associated with having cancer.
Taking Charge: Men’s Program is a group
program for men living with cancer and
men who are caring for a family member
with cancer. Men attend on a monthly basis,
and the men talk! Although the group is
made up of men from diverse backgrounds
with different diagnoses, treatments and
side-effects, each has real life experiences
with cancer. Real life experience lets them
find common ground when openly sharing
information, or asking about issues that in
other situations might be uncomfortable.
Courageous conversations about mortality,
sex and intimacy, the “voices in your head”
that replay tough scenarios, faith, fears,
and much more, are explored together in a
group setting. These conversations honour
the safety that men feel talking with other
men, and the way the information helps
them help themselves, as well as prepare
others for what may lay ahead.
According to Paul Soren, MSW, RSW,
cancer survivor and leader of Wellspring’s
m e n’s pr o g r a m m i n g , “Ev e r y one ’s
experiences have tremendous meaning for
the group as a whole. Men find it easier to
have these difficult conversations in a group
setting with other ‘guys who get it’.”
Participating in a group helps both patients
and caregivers feel less isolated and more
connected to information and resources,
and lets them establish a network of peers,
which is a vital step on the road to overall
well-being. Men feel comfortable sharing
private issues as they also know that all
information is kept strictly confidential
to ensure and respect each others’ dignity
and privacy.
Wellspring Cancer Support Network helps
with the many personal challenges that
come with a cancer diagnosis. It is a warm
and welcoming community that provides
more than 40 professionally-led programs
that address the emotional, social, practical
and restorative needs of cancer patients and
their family members, through compassion
and understanding. www.wellspring.ca
6
PATIENT & FAMILY EDUCATION NEWS Finances
DENISE BILODEAU, Social Worker,
OCC
Cancer can have an impact on
many aspects of people’s lives,
not the least of which could be
their finances. In a 2009 national
survey, 91% of those who had
a cancer diagnosis reported
experiencing a significant loss of
income and increased personal
expenses created by travel, meals,
parking, long distance phone
calls, alternative treatments,
prescription drugs, and much
more. One in six Ontario cancer
patients reported that the costs
involved in their cancer care were
unmanageable.
Some households lose two incomes, as both
the person with cancer and the primary
caregiver are forced to stop working.
While a portion of this lost income can be
recovered by some of the many provincial
and federal income replacement programs,
they are subject to conditions and require
application processes with wait times for
payment. Patients and their families may
need to be on multiple income replacement
programs, and understanding the different
eligibility requirements and programs
available can be a daunting task. This
article is intended to give a brief overview
of potential sources for income replacement
at a time of illness.
If you are required to take a leave from
your work as a result of your diagnosis
and treatment, there are several avenues
to explore for income support, including:
Benefits through your
employer
Ask your employer about benefits that may
be available at your work, such as short or
long term disability, sick leave and paid
vacation days.
Disability Insurance
Disability insurance may be part of your
employee benefits package or you may
have chosen to purchase it independently
7
if you are self employed (work for yourself)
and provides for some replacement of your
regular income should you become ill. In
addition, review your personal insurance
policies or check with your insurance agent
to find out if you have other insurance
coverage, such as critical illness insurance.
Employment Insurance (EI)
Sickness Benefits
If you are employed, but not able to work
for medical reasons, you could be eligible
to receive up to a maximum of 15 weeks
of EI sickness benef its. http://w w w.
servicecanada.gc.ca/eng/sc/ei/index.shtml
Employment Insurance (EI)
Compassionate Care Benefits
If you have to be away from work
temporarily to provide care or support to a
family member who is gravely ill, you could
qualify for up to a maximum of six weeks
of compassionate care benefits.
Canada Pension Plan
Disability (CPP-D)
If you are under age 65, have contributed to
the CPP for at least four of the previous six
years (or if you have been contributing for
at least 25 years, then only three of the last
six years) and meet the disability criteria,
you could be eligible to receive a CPP-D
pension. http://www.servicecanada.gc.ca/
eng/services/pensions/cpp/disability/index.
shtml
The Ontario Disability
Support Program
Provides financial help for people with
disabilities. To qualify you must meet
the financial criteria and have a proven
substantial physical or mental disability.
http://w w w.mcss.gov.on.ca/en/mcss/
programs/social/odsp/
Other areas for financial support or ways to
recoup costs for your care include:
Life insurance policies
Some policies allow for your premiums
to be waived in times of critical illness,
while others in instances of a terminal
cancer diagnosis, may allow money to be
withdrawn while living to help with added
SUMMER 2015
expenses. Contact your insurance company
to see if these apply to you.
Veterans Affairs Canada
If you are a veteran, you may be eligible
for financial help for medical care or
equipment. http://www.veterans.gc.ca/
eng/services/financial
Mortgage, car insurance &
credit card insurance
Check with your lenders to see if you have
disability coverage with your creditor.
Tax deductions for medical
costs
Some medical expenses may be claimed
as a tax deduction, (i.e. prescription,
accommodation and travel costs). Disability
tax credits are also available for those
eligible. http://w w w.cra-arc.gc.ca/tx/
ndvdls/tpcs/ncm-tx/rtrn/cmpltng/ddctns/
lns300-350/330/llwbl-eng.html
Northern Health Travel Grant
Program
The Ontario Ministry of Health and LongTerm Care provides grants to help with the
cost of transportation and accommodation
for residents of specified Northern Ontario
districts who must travel at least 100 km
(one-way) to receive medical services that
are not available in their communities.
http://www.forms.ssb.gov.on.ca/mbs/ssb/
forms/ssbforms.nsf/GetAttachDocs/0140327-88~5/$File/0327-88E.pdf
Trillium Drug Program
(TDP)
This program helps individuals and families
who have high prescription drug expenses.
This is a cost-sharing program based on
your household net income and every
resident of Ontario is eligible to enroll.
It can be a difficult process to determine
where your financial assistance can come
from, especially when you are already
managing your cancer care. Oncology
social workers and drug reimbursement
specialists are available though the Odette
Patient and Family Support Program to
help people connect to the resources they
require and for which they might be eligible.
EDUCATION: WHEN IT MATTERS MOST Urinary Incontinence
DEBBIE MILLER, RN, BScN, MN, CETN (C), Ostomy Advanced Practice Nurse
What is urinary
Incontinence (UI)?
Urina r y incontinence (U I) is the
uncontrolled loss of urine (pee). It is
a common and often embarrassing
problem. Bladder control loss can range
from leaking urine when you cough or
sneeze to having an urge to urinate that’s
so sudden and strong you don’t get to a
toilet in time. It is not a disease but a
symptom that is part of an underlying
problem or condition. Individuals with
UI often suffer in silence because they are
embarrassed, feel ashamed, are frustrated
and feel helpless. This can lead to low self
esteem and can make for a poor quality
of lie. People who suffer from UI may feel
like they cannot go out and enjoy their
normal lives.
How common is it?
Up to 3.3 million Canadians, nearly
10% of the population have some form
of urinary incontinence. (http://www.
canadiancontinence.ca/EN/index.php)
To prevent urine loss, people need to be
able to store urine, empty their bladder
well, have adequate mobility, dexterity and
cognitive function, have the motivation
to be continent (not leak urine) and live
in an area that is free of barriers.
What can cause it?
There are many reasons why you can have
UI. (See list below). It is important to tell
your care provider if you have leakage
of urine so the reason for this can be
found. Family doctors, nurses who are
experts in incontinence physiotherapists
and urologists can do an assessment and
special exams to help find the cause and
give you ways to manage your UI.
List of UI causes:
Weakened pelvic floor muscles or urethral
sphincters (childbirth, pregnancy, pelvic
or abdominal surgery, radiation therapy).
•
Menopause and older age (enlarged
prostate; decreased estrogens)
•
Heredity
•
Obesity
•
Chest infections (coughing)
•
Constipation
•
Urinary tract infections
•
Smoking
•
Alcohol
•
Conditions that affect the nervous
system (eg. stroke, spinal cord injury,
multiple sclerosis)
•
Surgery in the pelvis (Prostatectomy,
Hysterectomy, Rectal surgery)
•
Pelvic radiation
•
Side effect of medications
•
Birth defects
Types of incontinence:
Urge incontinence: the involuntary
passage of urine occurring soon after a
strong sense of urgency to void (urinate).
Stress incontinence: is a loss of urine with
coughing and or sneezing resulting in
increased abdominal pressure.
Mixed incontinence: is urine loss having
features of both stress and urge.
Overflow incontinence: is the involuntary
loss of urine associated with bladder
over-distention.
Functional incontinence: is urinary
leakage associated with the inability to
access the toilet because of impairment
of cognitive and/or physical functioning
or an environmental barrier.
Transient incontinence: is urine loss
resulting from causes outside of or
affecting the urinary system such as acute
confusion, infection, atrophic urethritis
or vaginitis, medications, psychological
conditions, restricted mobility or stool
impaction.
Total incontinence: is a continuous and
unpredictable loss of urine. (RNAO,
BPG, 2005)
What should I do if I have
urinary incontinence?
Talk to your health care
team:
It is important to let your health care
team know that you have UI. This is
not something to stay silent about as it is
a very common problem that can often
be managed. Sometimes medication or
surgery may be needed. Telling your
health care team you have UI helps
them find the best way to manage your
symptoms and help improve your overall
quality of life. They can also suggest the
best person to do a continence assessment
so the most effective, individualized
strategies can be determined to improve
your continence.
L i s te d b e low a re s ome c om mon
suggestions that help people with
UI. These are based on the type of
incontinence the person has.
Maintain a healthy diet and
drink the right amount of
fluid:
Eating a healthy diet (with fibre) helps
maintain your overall health and helps
with keeping you at a healthy weight. It
can also help prevent constipation. Avoid
spicy foods, tomatoes or foods/drinks
with artificial sweeteners. Doing this
can help lessen irritation to your bladder.
continued on pg 9...
8
PATIENT & FAMILY EDUCATION NEWS SUMMER 2015
continued from pg 8...
Drink 6-8 glasses of f luid each day.
(Avoid drinking a lot of fluid a few hours
before going to bed). Try to reduce or take
out caffeine from your diet. Try to stay
away from drinks with alcohol or lower
the amount you drink.
Prevent constipation:
Drink 6-8 glasses of fluid per day and
when able to do this, increase your fibre
intake (25-30 gm/day). Try to do regular
exercise for 30 minutes every day. Try
and find a regular time to have a bowel
movement and make sure you are sitting
comfortably on the toilet with your feet flat
on the floor. Take medications as needed
to help you with regular bowel function.
Talk to one of our registered dietitians or
one of our pharmacists for more tips.
Stop smoking:
Smoking can increase your risk of getting a
chest infection. Coughing can make stress
incontinence worse. It can also make urge
incontinence worse as the nicotine has a
stimulant effect on the bladder muscle
which causes the bladder to contract. For
more information on smoking cessation:
http://sunnybrook.ca/calendar/event.
asp?e=843&m=295&page=33990...
Make your Pelvic Floor
Muscles stronger:
Learn how to do pelvic f loor muscle
exercises (Kegels). These can help people
who suffer from urge or stress UI. If you
have had bladder, prostate, rectal or pelvic
surgery, you should speak to your surgeon
about when to start these exercises.
Kegel exercises: (can be done lying, sitting
or standing).
9
•
Pretend you need to stop gas from
passing and squeeze the muscles in
the anus.
•
Do not tighten your abdomen,
buttock or thigh muscles.
•
Hold the contraction (tightening) for
3 seconds, then relax for 3 seconds.
Remember to breathe.
•
Repeat the exercise 10 times (this
is 1 set).
•
Do 1 set three to 5 times per day.
Once you are able to hold the contraction
well for 3 seconds, you can hold
your contraction up to 5-10 seconds.
Remember to rest the same amount of
time in between contractions.
Use Containment Aids/
Products:
There are products you can buy to help
with the containment of urine. Products
that are made for leakage of urine can
better absorb urine and prevent the
skin around the urethra from becoming
irritated. When you go to choose a UI
product it is important to know the
types of products available, the amount
of absorbency, overall durability, noise
factor, comfort and fit, odor containment,
ease of use and cost.
Types of containment devices include:
Pads (adhesive/non-adhesive); absorbent
pouches (for men); belted, button or
velcro briefs, protective underware, full
briefs (diaper) or reusable products.
Other products include condom catheters
(for men) or urethral catheters that
can be used for those with overf low
incontinence. Waterproof protective pads
are good for beds or seating surfaces. It
is important to protect your skin if you
suffer from inwcontinence. Products to
help protect your skin include barrier
wipes, creams, ointments or peri-wash
cleansers. Many of these products can be
found in drug stores or specialty health
care stores. Ask for help when you are
choosing these products.
Helpful tips for functional
incontinence:
Think about renting or buying toileting
aids. These include urinals, bedpans,
commodes or a raised toilet seats. Mobility
aids such as a cane or walker can also help.
Clothing should be easy to remove. Wear
clothes that do not have buttons. This
can make going to the toilet easier. Make
sure your home or living space is free of
clutter and that a path is clear to get to
the washroom. Occupational Therapists
can help you with this and give you tips
on how to find ways to make going to
the toilet easier.
For additional information, several
resources have been identified below.
Debbie Miller, RN, BScN,
MN, CETN(C)
Ostomy Advanced Practice Nurse
Recommended Resources:
Canadian Association for Enterostomal
Therapy: https://w w w.caet.ca/caetenglish/about.htm
Canadian Continence Foundation:
http://www.canadiancontinence.
ca/EN/index.php
Canadian Nurse Continence
Advisors: http://www.cnca.ca
Registered Nurses Association of
Ontario: Promoting Continence
Using Prompted Voiding (2005):
http://rnao.ca/sites/rnao-ca/files/
Promoting_Continence_Using_
Prompted_Voiding.pdf
Incontinence: The Canadian
Perspective (December, 2014):
http://www.canadiancontinence.
ca/pdfs/en-incontinence-acanadian-perspective-2014.pdf
Incontinence Products:
TENA: http://www.tena.ca
Poise: http://www.poise.com
Attends: http://www.attends.com
Depends: http://www.depend.com
EDUCATION: WHEN IT MATTERS MOST Have a question related to your cancer
treatment & care?
Email us at:
[email protected]
Patient Education and Research Learning Centre (PEARL)
Do you have questions? Want to learn more? Please visit the PEARL!
Phone: (416) 480-4534
Email: [email protected]
Location: Odette Cancer Centre (T-wing)
1st floor beside main reception (T1-156)
Please drop by for more information!
Open: Monday thru Friday
9:00 am to 4:00 pm
10
Patient & Family Support
At Odette Cancer Centre
Services before, during and after treatment to help you with:
Managing stress and worry
Coping with changes in your health
Finding supports and resources specific for your cancer
Financial and work concerns
Nutrition questions or concerns
Managing daily activities at home
Managing fatigue
Paying for your drugs
We are part of your health care team. Our services are free of charge.
You can drop-in today:
416-480-4623
TG-230
(T-Wing, ground floor)